Knee
> Kneecap
Dislocation > Treatments
Physical Therapy
Home Recovery
Your physician may prescribe visits to a physical therapist
to begin supervised range of motion and strengthening
exercises after a kneecap dislocation. Most people make
one or two visits to the therapist to learn a home stretching
and strengthening program. Your physician may prescribe
a brace to help avoid a repeat dislocation by helping
the kneecap track properly and preventing the knee from
bending too far. Your goal for the first few months
after a kneecap dislocation is typically is to avoid
a repeat dislocation by being smart about which activities
to avoid and to perform, and to be consistent with your
conditioning and physical therapy to keep your muscles
pulling evenly on your kneecap. The majority of patients
feel significant pain relief when doing muscle strengthening
exercises and staying away from activities that bend
the knee more than 90 degrees. Physical therapy can
help train the muscles around the kneecap to pull evenly
in all directions, keeping your kneecap in normal alignment.
You usually need to stay off your feet for about ten
days after a dislocation. The real key is relative rest.
This means staying away from activities that put excessive
pressure on the knee while strengthening the knee so
the kneecap will track properly. It is important to
refrain from activities that cause pain. In general,
any activity that puts a heavy load or strain on your
knees with the knee bent beyond 90 degrees should be
avoided. This includes heavy running, bicycling with
the seat too low, climbing, yoga, and stretches, like
the classic hurdler's stretch, where the heel is brought
up to the buttocks.
Usually, you will be asked to try a well-supervised
rehabilitation program for between six weeks for a subluxation
and up to six months for a dislocation. In most cases,
you will need to continue the exercises you learn in
physical therapy for your entire life. After a dislocation,
the knee is immobilized for four to six weeks. After
a subluxation, motion is resumed when the pain decreases
enough to make it tolerable. Generally, most people
can begin range of motion and strengthening exercises
within a week after a subluxation. Your physician and
physical therapist can help design a customized rehabilitation
program that is best for you. You will start slowly
with range of motion exercises and proceed to stretching
exercises. In most cases, patients respond to non-operative
treatment. Most people can begin stretching the muscles
and tendons around the kneecap within a week. Physical
therapy after a kneecap dislocation follows a general
pattern. It often involves an elaborate daily stretching
routine that helps ensure muscles pull evenly on your
kneecap. When stretching, try to avoid bending your
knee past 90 degrees, which is roughly the knee angle
when sitting in a chair with your feet flat on the floor.
Rehab progresses into strengthening exercises that focus
on the quadriceps and hamstrings the main stabilizing
muscles for your knee. Physicians suggest you gradually
increase the amount of weight as your leg muscles get
stronger. Strengthening exercises require dedication
because results often take weeks and pain may recur.
After about six to 12 weeks of rehab, physical therapy
can become activity-oriented as you regain the ability
to perform complicated movements, using stationary bikes,
elliptical machines, and cross-country skiing machines.
Coordination exercises continue for months until your
kneecap is fully rehabilitated. Physicians usually suggest
that you continue strength training even after your
kneecap has been rehabilitated. Have your physician
periodically check your kneecap for strength and proper
tracking.
RELATED TOPICS
Knee
strengthening exercises: Kneecap (patella) injuries
Your main prevention goal following
kneecap dislocation should be to strengthen your quadriceps
and hamstring muscles so they are stronger than before
the dislocation. You should try to feel comfortable
that your leg muscles are powerful enough to snugly
keep your kneecap in a normal alignment. Physicians
usually suggest that you wear your knee sleeve during
any activities that may stress your knee. The knee sleeve
by itself may improve the tracking of your kneecap,
however, to prevent kneecap dislocations, your rehab
exercises are ultimately more important than bracing.
Making the strengthening exercises you learned in rehab
part of your regular conditioning routine is the best
way to prevent future kneecap dislocations. Like any
dislocated joint, once the first dislocation occurs,
less force may provoke subsequent dislocations. You
will have to rely much more on muscle strength to hold
your kneecap in a normal position after a dislocation.
Depending on the severity of your dislocation and the
success of your rehab program, your physician may recommend
that you avoid contact sports or risky, high-speed activities.
In general, your kneecap can become healthy and stable
after a dislocation, but you may need to be cautious
of activities that could result in accidental collisions
or falls. Besides the knee sleeve, consider wearing
sturdy kneepads designed for crashes during activities
like in-line skating and padded knee braces during contact
sports. Your physician can recommend the best types
of protective gear for your knees. You may know some
people who seem able to pop their joint in and out of
place painlessly. This should be avoided at all costs.
The more your kneecap is popped out of place, the greater
your chances of arthritis and the higher your risk of
re-injury during activities.
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